Kidney Transplant

Kidney Transplant COM/150 June 6, 2010 Axia College of University of Phoenix Kidney disease has become more prevalent over the years, one in nine Americans has chronic kidney disease, resulting in the need for a kidney transplant. Kidney failure is caused by variety of factors resulting in damage of the nephrons, which are the most important functioning unit of the kidneys. Kidney failure can be broken down into three groups: acute, chronic, end-stage. Once kidney failure is irreversible, dialysis or transplantation is the only method of survival.

To avoid a kidney transplant, one needs to be aware of the pre-disposing factors, signs and symptoms, available treatments, and proper diet. The kidneys are twin organs about the size of a fist, and are at the lowest part of the rib cage on both sides of the spine (National Kidney Foundation, 2010). They have multiple working units called nephrons. “Nephrons consist of a filtering unit of tiny blood vessels called a glomerulus which is attached to a tube” (National Kidney Foundation, 2010).

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In the filtering process, “the blood enters the glomerulus in which it is filtered and the remaining fluid goes through the tubule,” in which chemicals and water are added or removed depending on what the body requires. The excess fluid is then removed through urination, the final phase of the function of the kidneys (National Kidney Foundation, 2010). The kidneys also produce hormones that maintain strong bones and healthy blood. Kidney failure occurs when the kidneys cannot properly eliminate waste from the body, and this causes accumulation of fluids and waste products.

There are three types of kidney failure: Acute kidney failure develops unexpectedly because of severe infection, drugs or other chemical agents, or by physical trauma. Chronic kidney failure normally occurs over years and is manifested by several symptoms such as weight loss, low blood count, and nausea. End-stage kidney disease is the final stage and can lead to other diseases such as bone and heart diseases. It can also end in the need for kidney transplant or death (Stevens, 2009). Kidney disease affects about 26 million Americans which translate into one in nine adults with the disease.

Kidney disease is more commonly found among certain ethnic groups, for example, African Americans who make up a large percentage, Hispanics, Pacific Islanders, and Native Americans. It also affects senior citizens across racial and ethnic barriers (Nation Kidney Foundation, 2010). African Americans are more likely to develop kidney disease, for the reason that they are more prone to have diabetes and high blood pressure. The National Kidney Foundation states the following facts: African Americans suffer from End Stage Renal Disease disproportionately.

In 2004, the incidence of kidney failure per million populations was 968 in African Americans, compared with 263 in White Americans. African Americans constitute about 32 percent of all patients treated for kidney failure in the U. S. , but only about 12 percent of the overall U. S. population. African Americans also develop kidney failure at an earlier age than White Americans. In 2006, the mean age for African Americans at the start of treatment for kidney failure was 56. 4 years, compared with 59. 6 in White Americans. (National Kidney Foundation, 2010) If detected early, kidney disease can be effectively treated and reversed.

An awareness of the signs and symptoms of the disease is of primary importance. The number one physical sign of kidney disease is the change in urination, the constant urge to urinate, the presence of blood in the urine, and decrease in the volume of urine. Another physical sign of kidney disease is the swelling of the face, hands, ankles, and feet. Other physical signs and symptoms include: fatigue, skin rash, nausea and vomiting, shortness of breath, dizziness, headache, poor appetite, nose bleed, metallic taste in the mouth, and the inability to concentrate (Life Options, 2010).

Diagnostic tests such as Glomerular filtration rate (GFR) measures the level of kidney function and determine the stage of kidney disease. Specific blood tests also can be an accurate diagnostic tool. A kidney biopsy can also provide accurate results. Chest x-ray, ultrasound, and electrocardiogram can be effectively used (Stevens, 2009). According to National Kidney Foundation (2010), the majority of people with diabetes tend to develop kidney disease. This is probably the result of poor or improper dietary and life-style practices, although genetics seem to be a factor.

This makes it the single leading cause of kidney failure. High blood pressure/Hypertension is another pre-disposing factor of kidney failure. This disease is also aggravated by improper dietary and life-style practices. High blood pressure/Hypertension speeds up the loss of kidney function and eventually leads to kidney failure. It also appears to have genetic and familial factors (National Kidney Foundation, 2010). Kidney failure is the result of kidney disease that has either not been treated, or failed to respond to treatment.

Some kidney diseases are: Acute kidney failure (potentially reversible), Acute nephritic syndrome, Goodpasture syndrome, Atheroembolic renal disease, Glomerulonephritis, Polycystic kidney disease, and chronic kidney failure (end stage) (United States National Library, 2010). The usual treatment for kidney failure is medication and dialysis. Dialysis is used for end stage kidney failure, when the patient has lost anywhere from 85% to 90% of kidney function. National Kidney Foundation (2010) states, the five stages of chronic kidney disease: 1. Kidney damage with normal GFR (when the GFR is 90 or greater). 2.

Kidney damage with mild decrease in GFR (when the GFR is 89-60). 3. Moderate decrease in GFR (when the GFR is 59-30). 4. Severe reduction in GFR (when the GFR is 29-15). 5. Kidney failure (when the GFR is less than 15). Dialysis helps to keep the body in proper working order by removing waste product from the blood by an external “man-made” filtering process. The two types of dialysis are: Peritoneal dialysis and Hemodialysis. The two major kinds of peritoneal dialysis are: “Continuous Ambulatory Peritoneal Dialysis (CAPD) and Continuous Cycling Peritoneal Dialysis (CCPD)” (National Kidney Foundation, 2010).

The CAPD is the only type that does not require a machine, whereas the CCPD requires the cycler machine. Peritoneal dialysis allows the patient to be more independent in that the procedure can be done at home, work, or even in a hotel room. In performing peritoneal dialysis, the patient has to be careful to maintain sterility to prevent infections. Hemodialysis must always be done in a center, by professionals. If a patient has to travel outside the area in which dialysis is done, an alternate center has to be located a head of time so that the procedure can be performed (National Kidney Foundation, 2010).

The procedure normally takes approximately four hours and is it usually done about three times per week (Monday/Wednesday/Friday). When medication and dialysis are ineffective, there is the need for kidney transplant. Before a transplant takes place, a screening process is necessary to select a suitable donor. There are two types of donors, living and non-living (National Kidney Foundation, 2010). Donations can be from family members as well as strangers. Living donations are easier to monitor post-operatively because they begin to function immediately.

Recipients of nonliving donations sometimes require dialysis until the kidney begins to function adequately. Post-operatively the recipient receives specific medications (anti-rejection medications) to prevent rejection of the implanted kidney. Rejection is the most important complication associated with a transplant. Because the body’s immune system protects against foreign matter, it may recognize the new tissues as foreign and fight against them (National Kidney Foundation, 2010).

National Kidney Foundation, (2010) states that, there are three types of medications required in the prevention of rejection: the first is cyclosporine or tacrolimus. Next, is a specific type of steroids and finally mycophenolate mofetil or azathioprine. Pain killers are needed immediately after surgery. Individualized nursing care is a requirement for both donor and recipient. The patients are placed in the Intensive care unit for close observation. Attention must be given to diet after a kidney transplant to ensure that the recipient remains in good health.

Diabetics or patients who received dialysis before transplant need to follow their prescribed diet and the same applies to people with high blood pressure (National Kidney Foundation, 2010). The restriction of salt and sugar intake, increase in fiber, decrease in saturated fat intake, and drinking enough water are all important dietary guidelines to follow. In conclusion, kidney disease is growing rapidly and mostly in the community of minorities and the elderly. Although kidney disease may result to serious diseases and even death, the most preventable prevention is awareness. Unfortunately, CKD often cannot be cured. But people in the early stages of CKD may be able to make their kidneys last longer by taking certain steps” (National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health 2010). For example, controlling diabetes, blood pressure and diet are important factors in the prevention of kidney transplant. Kidney disease does not have to result to kidney failure. To avoid a kidney transplant, one needs to be aware of the pre-disposing factors, signs and symptoms, available treatments, and proper diet.

Reference 10 Symptons of Kidney Disease, Life Options (2010). Retrieved from http://www. lifeoptions. org on May 12, 2010. How Your Kidneys Work, Nation kidney foundation (2010). Retrieved from http://www. kidney. org on May 12, 2010. Stevens, L. M. , Lynm,C, Glass, R. M. Kidney Failure, Jama (2009). Retrieved from http://jama. ama-assn. org United States National Library of Medicine National Institute of Health. United States National Library of Medicine National Institute of Health Kidney Diseases, (2010). Retrieved from http://www. nlm. nih. org on May 12, 2010.


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